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Correlation of Hamstring Tendon Size in Pre-Operative MRI Measurement with Intra-Operative Graft Size in Primary Anterior Cruciate Ligament (ACL) Reconstruction
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作者 Nurhanani Abu Bakar Mohamad Razip Sirat +1 位作者 Hairiah Abas Saiful Safuan Md Sani 《Journal of Biosciences and Medicines》 2024年第3期150-158,共9页
Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation o... Background: The size of Hamstring autograft of less than 8.0 mm in ACL re-construction is one of the key factors that may contribute to the failure of the graft. In this study, we are going to assess the correlation of pre-operative MRI measurement of Hamstring tendons with the intra-operative ACL graft. Thus, it may help surgeons to anticipate the needs for graft augmentation should the final graft size be smaller than expected. Methods: We retrospectively re-viewed 41 cases of ACL reconstructions in which MRI were done pre-operatively, in Hospital Pakar Sultanah Fatimah (HPSF), Muar between January 2019 until December 2022. MRI measurements of Hamstring tendon (semitendinosus: ST, and gracilis) were done by a radiologist, and the in-tra-operative notes were reviewed for the final graft size. Pearson’s correlation coefficients were calculated to determine the relationship between graft size and tendon cross-sectional area. The intraclass correlation (ICC) by using two-way mixed model with type consistency, the reliability based on average measure was 0.41 (95% CI: ?0.10, 0.69). A p-value < 0.05 was considered sig-nificant. Results: Of 105 patients with primary ACL reconstruction done be-tween January 2019 to December 2022, only 41 patients were included in this study. There was fair correlation (p = 0.048) between pre-operative MRI measurement and the graft diameter intra-operatively. The mean of 17.0 mm of combined diameter of ST and gracilis tendon in MRI may results in graft diameter of 8.3 mm. There was also positive correlation between patients’ height and the intra-operative graft size. Conclusion: These results showed good correlation between pre-operative MRI measurement of Hamstring ten-don size with the intra-operative graft size, hence it is a reliable tool to predict the Hamstring autograft size in ACL reconstruction. 展开更多
关键词 ACL Reconstruction Pre-Operative MRI hamstring tendon
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A Single Bundle Anterior Cruciate Ligament Reconstruction (ACL-R) Using Hamstring Tendon Autograft and Tibialis Anterior Tendon Allograft:A Comparative Study 被引量:4
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作者 Saroj Rai Sheng-yang JIN +5 位作者 Bimal RAI Nira TAMANG Wei HUANG Xian-zhe LIU Chun-qing MENG Hong WANG 《Current Medical Science》 SCIE CAS 2018年第5期818-826,共9页
The main purpose of this study patients undergoing a single bundle anterior was to compare the clinical outcomes of cruciate ligament reconstruction (ACL-R) of using quadrupled hamstring (4HT)autografts and two-strand... The main purpose of this study patients undergoing a single bundle anterior was to compare the clinical outcomes of cruciate ligament reconstruction (ACL-R) of using quadrupled hamstring (4HT)autografts and two-strand tibialis anterior (2TA) aUografts,and to find out the rate of graft failure and possible causes.We hypothesized that there would be no difference in the clinical outcome,and graft failure would be associated with the use of small sized allograft in young active males with high demand of sports activities.We retrospectively evaluated 222 patients (male,n=167,female,n=55) undergoing ACL-R between January 2010 and July 2014.Of 222 patients,115 were included in the 4HT autograft group and 107 patients in the 2TA allograft group.Inclusion criteria were primary unilateral ACL-R with a minor MCL (<grade Ⅱ)injury with or without meniscus tear and had at least 2.5 years of follow-up.Subjective evaluation was performed using Tegner-Lysholm score,modified Cincinnati knee score,and IKDC knee form.Anteroposterior laxity was assessed using ADT and Lachman test whereas rotational laxity was assessed using pivot shift test.Similarly,functional assessment was performed using range of motion (ROM),Daniel's one-leg hop test,and overall IKDC score.Clinical outcomes were satisfactory and comparable in both groups with no statistically significant difference in all the respective parameters.No statistically significant difference was observed in graft re-rupture rate.However,most graft failures occurred in young active males with high demand of sports activities,graft size smaller than 8 mm,and use of allograft.An autograft with at least 8 mm diameter should be considered in a young active male with high demand of sports activities to avoid graft failure. 展开更多
关键词 ANTERIOR CRUCIATE ligament reconstruction AUTOGRAFT ALLOGRAFT hamstring tendon tibialis ANTERIOR tendon
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Arthroscopic Reconstruction of the Posterior Cruciate Ligament with a Ligament-advanced Reinforcement System and Hamstring Tendon Autograft:A Retrospective Study 被引量:5
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作者 Yang LUO Zhi-gang WANG +1 位作者 Zhi-jiang LI Min WEI 《Current Medical Science》 SCIE CAS 2021年第5期930-935,共6页
Objective:Both ligament-advanced reinforcement system(LARS)and hamstring tendon autograft can serve as grafts for posterior cruciate ligament(PCL)reconstruction.However,few studies have compared the effectiveness of t... Objective:Both ligament-advanced reinforcement system(LARS)and hamstring tendon autograft can serve as grafts for posterior cruciate ligament(PCL)reconstruction.However,few studies have compared the effectiveness of these two approaches.This study therefore aimed to compare the clinical efficacy of arthroscopic reconstruction of the PCL using either the LARS or hamstring tendon autograft.Methods:A total of 36 patients who underwent PCL reconstruction were retrospectively analyzed.Within this cohort,15 patients received a reconstruction using the LARS(LARS group)and 21 using the hamstring tendon autograft(HT group).Results:The pre-and post-operative subjective scores and knee stability were evaluated and the patients were followed up for a period of 2 to 10.5 years(4.11±2.0 years on average).The last follow-up showed that functional scores and knee stability were significantly improved in both groups(P<0.05).Six months after operation,Lysholm scores and IKDC subjective scores were higher in the LARS group than in the HT group(P<0.05).Nonetheless,the last follow-up showed no significant differences in the functional scores or the posterior drawer test between the two groups(P>0.05).In the LARS and HT groups,12 and 9 patients,respectively exhibited KT1000 values<3 mm,with the difference being statistically significant(P<0.05).In the HT group,the diameter of the four-strand hamstring tendon was positively correlated with height(P<0.05),which was 7.37±0.52 mm in males and 6.50±0.77 mm in females(P<0.05).Conclusion:Both LARS and hamstring tendon approaches achieved good efficacy for PCL reconstruction,but patients in the LARS group exhibited faster functional recovery and better knee stability in the long term.LARS is especially suitable for those who hope to resume activities as early as possible. 展开更多
关键词 posterior cruciate ligament ligament-advanced reinforcement system hamstring tendon RECONSTRUCTION
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Reconstruction of the Medial Patellofemoral Ligament Using Hamstring Tendon Graft With Different Methods:a Biomechanical Study 被引量:1
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作者 Wei He Yu-ming Yang +2 位作者 Ming Liu Ai-yuan Wang Yu-jie Liu 《Chinese Medical Sciences Journal》 CAS CSCD 2013年第4期201-205,共5页
Objective To measure the tensile strength of the normal medial patellofemoral ligament(MPFL),and evaluate the biomechanics of different fixation methods of the hamstring tendon graft on the patella.Methods Eight fresh... Objective To measure the tensile strength of the normal medial patellofemoral ligament(MPFL),and evaluate the biomechanics of different fixation methods of the hamstring tendon graft on the patella.Methods Eight fresh cadaver knees were prepared by isolating the patella,leaving only the MPFL as its attachment to the medial condyle of femur.The MPFL was reconstructed by three different methods:four-suture fixation,anchors-single suture fixation,and anchors-double suture fixation.The tensile strength and the elongation of the normal MPFL and the tendon grafts were measured.Results The tensile strength of the four-suture fixation group(234.86±49.02 N)was stronger than that of the normal MPFL(146.91±25.30 N,P=0.0014)and the anchors-single suture group(159.17±49.07N,P=0.0077),while weaker than that of the anchors-double suture group(314.74±78.46 N,P=0.0052)Conclusions With regard to the tensile strength,the four-suture fixation method is reliable for clinical use.Compared with the anchor-suture method,the four-suture fixation method which has no specific implants is more economical,convenient and efficient. 展开更多
关键词 medial patellofemoral ligament BIOMECHANICS fixation method hamstring tendons
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MRI Observations of Patellar Tendon Length Change after ACL Reconstruction with Hamstring Autografts
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作者 李皓桓 张小龙 +3 位作者 Gota Ooi Numazaki Hironori Miho Sekiguchi Shin-ichi Konno 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2017年第4期577-581,共5页
The post-operative patellar tendon length was studied to evaluate the possible tendon length change after anterior cruciate ligament(ACL) reconstruction with hamstring autografts. The Insall-Salvati index, modified ... The post-operative patellar tendon length was studied to evaluate the possible tendon length change after anterior cruciate ligament(ACL) reconstruction with hamstring autografts. The Insall-Salvati index, modified Insall-Salvati index, curved modified Insall-Salvati index and Caton-Deschamps index were observed by MRI during a follow-up period of 12 weeks on 20 ACL reconstructed knees. The results showed no patellar baja or alta pre-existed on those ACL injured patients. After a follow-up period of 12 weeks, no patellar tendon length change was observed. It is suggested that the change of patella was not the primary reason that may contribute to the premature patellofemoral joint osteoarthritis after ACL reconstruction. 展开更多
关键词 patellar tendon hamstrings anterior cruciate ligament reconstruction
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Five Strand Hamstring Tendon Autograft for Anterior Cruciate Ligament Reconstruction Provides No Benefit over the Gold Standard Four Strand Repair for Anterior Stability of the Knee: A Prospective Cohort Study
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作者 A.Sideris A.Hamze +2 位作者 N.Bertollo D.Broe WR Walsh 《Open Journal of Orthopedics》 2017年第6期156-172,共17页
The Four-Strand Hamstring Tendon Autograft has been long established as the gold standard for surgical reconstruction of the Anterior Cruciate Ligament. Some studies have suggested wider grafts, such as a Five-Strand ... The Four-Strand Hamstring Tendon Autograft has been long established as the gold standard for surgical reconstruction of the Anterior Cruciate Ligament. Some studies have suggested wider grafts, such as a Five-Strand hamstring graft, may provide greater strength and a larger scaffold for incorporation of the graft into the bone tunnels, leading to greater postoperative anterior stability of the knee. 28 (n = 18 Four-Strand and n = 10 Five-Strand) patients with planned ACL reconstructive surgery by a single surgeon were recruited for this study. The KT-1000 Arthrometer (MED metric, CA, USA) was used to quantify AP translation in the subjects’ knees before (T0) and after surgery at 6 (T1) and 12 (T2) weeks. At 12 weeks there was significantly higher (p = 0.01) mean anterior laxity on Maximum Manual Test in the Five- Strand group (9.1 ± 1.7 mm) than the Four Strand Group (6.9 ± 2.3 mm). Further, there were significantly higher mean side-to-side differences (p = 0.01) on Maximum Manual Test in the Five-Strand cohort (5.1 ± 3.5 mm) compared to the Four-Strand cohort (1.9 ± 2.2 mm). A significantly larger positive mean change in anterior laxity (p = 0.02) from 6 - 12 weeks was evident in the Five-Strand group (1.4 ± 0.9) than the Four-Strand group (-0.3 ± 1.9 mm). No significant correlations were seen between graft widths and measures of anterior stability on KT-1000. This study illustrated that there was no benefit to using a Five-Strand Hamstring Tendon Autograft when compared to the gold standard Four-Strand Repair specifically with regards to anterior stability of the knee. 展开更多
关键词 ANTERIOR CRUCIATE LIGAMENT ACL ANTERIOR CRUCIATE LIGAMENT Reconstructive Surgery ANTERIOR CRUCIATE LIGAMENT Reconstruction ACL Reconstruction Five STRAND hamstring tendon AUTOGRAFT Four STRAND hamstring tendon AUTOGRAFT KT-1000 AP Translation Knee
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自体Hamstring腱重建前交叉韧带术后关节镜下再视观察 被引量:4
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作者 夏春 周江南 +1 位作者 付日斌 陈国能 《中国微创外科杂志》 CSCD 2005年第12期1006-1008,共3页
目的关节镜再视观察游离Hamstring腱重建前交叉韧带后在体内重塑与转归过程.方法关节镜下再视手术,观察关节镜下自体同侧游离Hamstring腱重建前交叉韧带33例.重建术至再视手术时间为2~36个月,平均11.9月.依据重建术至再视术的时间,替... 目的关节镜再视观察游离Hamstring腱重建前交叉韧带后在体内重塑与转归过程.方法关节镜下再视手术,观察关节镜下自体同侧游离Hamstring腱重建前交叉韧带33例.重建术至再视手术时间为2~36个月,平均11.9月.依据重建术至再视术的时间,替代腱按时段分组:1月~,4月~,7月~,10月~,13月~,18月~和25月~组.再视术重点观察评估了移植的Hamstring腱形状、色泽、张力、覆盖的滑漠组织和血管状况.结果再视关节镜下重建前交叉韧带的Hamstring腱随植入时间延长,其形态逐步向正常前交叉韧带重塑与转归;7月~组和此后各组的替代腱在关节镜视下表现为.一种几乎无滑膜和血管的灰白色粗壮的圆柱体,类似于正常的前交叉韧带组织,达到了在体内成熟的程度.结论自体游离多股Hamstring腱重建前交叉韧带术后具有良好早期存活,快速再血管化和重塑过程,其术后的重塑与成熟过程与自体髌腱的过程相似,但其在体内重塑与转归进程相对较快. 展开更多
关键词 自体hamstring 前交叉韧带重建术后 关节镜 重塑与成熟
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自体腘绳肌腱植入手术治疗重度阴道前壁脱垂的中期疗效
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作者 姚颖 王一婷 +4 位作者 杨俊芳 管祎琪 梅宇 韩劲松 张坤 《中国微创外科杂志》 CSCD 北大核心 2024年第4期271-277,共7页
目的探讨自体腘绳肌腱植入治疗重度阴道前壁脱垂的安全性和中期疗效。方法本研究为单臂临床试验,2021年5月开始纳入有症状、要求手术治疗的以阴道前壁重度脱垂为主的盆腔器官脱垂(pelvic organ prolapse,POP)患者,经患者充分知情,自愿... 目的探讨自体腘绳肌腱植入治疗重度阴道前壁脱垂的安全性和中期疗效。方法本研究为单臂临床试验,2021年5月开始纳入有症状、要求手术治疗的以阴道前壁重度脱垂为主的盆腔器官脱垂(pelvic organ prolapse,POP)患者,经患者充分知情,自愿选择自体腘绳肌腱添加修补,同时行双侧高位骶韧带悬吊。术后随访盆腔器官脱垂定量分度(pelvic organ prolapse quantification,POP-Q)、盆底不适调查表简表评分(Pelvic Floor Distress Inventory-Short Form 20,PFDI-20)、术后满意度评分、患者整体印象改善评分(Patient Global Impression of Improvement,PGI-I)。观察术后取腱侧下肢功能及术后并发症处理、再手术情况。结果取腱手术时间(19.7±8.3)min,盆底手术时间(122.1±37.8)min,术中出血量中位数70 ml(50~400 ml),无术中副损伤和术后病率。12例随访(26.4±2.5)月。Aa、Ba、C术前分别为3(-1~3)、5(2~10)、4(-1~10),术后24个月分别为-3(-3~3)、-3(-3~3)、-6(-6~3),差异有显著性(P<0.05)。12例术前、术后24个月PFDI-20评分分别为88.0(16.7~204.2)、8.3(0~32.3)分,差异有显著性(Z=-2.803,P=0.005);PGI-I问卷11例术后症状明显改善,1例有改善。术后6、24个月满意度评分分别为(4.8±0.4)分和(4.6±0.7)分。1例术后12个月自感阴道脱出物,阴道前壁及顶端脱垂Ⅲ度,复发率8.3%(1/12)。2例分别术后9 d、2周肺栓塞,Clavien-Dindo外科手术并发症分级分别为Ⅱ、Ⅲ级,分别门诊和住院治疗后痊愈。1例阴道顶端局部筋膜暴露,药物治疗好转。所有患者取腱部位切口愈合良好,肌力、下肢活动均正常。无因复发和筋膜条并发症再次手术。结论自体腘绳肌腱植入治疗重度阴道前壁脱垂手术安全,中期疗效满意。术前需向患者宣教下肢锻炼预防静脉血栓并发症。 展开更多
关键词 自体筋膜 腘绳肌腱 重度阴道前壁脱垂
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自体富白细胞-血小板纤维蛋白凝胶与腘绳肌腱修复创伤性髌骨脱位
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作者 王新民 闫文凯 +1 位作者 宋亚辉 刘飞 《中国组织工程研究》 CAS 北大核心 2024年第3期404-410,共7页
背景:临床上创伤性髌骨脱位合并内侧髌股韧带股骨止点或体部撕裂多采用内侧髌股韧带重建手术,为促进内侧髌股韧带重建术后的腱骨愈合,研究者采用了包括生长因子、干细胞、富血小板血浆在内的多种生物治疗技术。目的:探讨自体富白细胞-... 背景:临床上创伤性髌骨脱位合并内侧髌股韧带股骨止点或体部撕裂多采用内侧髌股韧带重建手术,为促进内侧髌股韧带重建术后的腱骨愈合,研究者采用了包括生长因子、干细胞、富血小板血浆在内的多种生物治疗技术。目的:探讨自体富白细胞-血小板纤维蛋白凝胶联合腘绳肌腱重建内侧髌股韧带修复创伤性髌骨脱位的临床疗效。方法:选择2019年2月至2021年2月秦皇岛市第一医院诊治的创伤性髌骨脱位患者37例,采用随机数字表法分为试验组(n=18)与对照组(n=19),试验组接受自体富白细胞-血小板纤维蛋白凝胶联合自体腘绳肌腱重建内侧髌股韧带手术,对照组接受单纯自体绳肌腱重建内侧髌股韧带手术。两组患者术后随访12个月,通过目测类比评分、Lysholm评分、Kujala髌股关节评分及膝关节活动度评估患者膝关节疼痛及功能状态,通过MRI及CT片测量髌股关节髌骨倾斜角、髌骨适合角及髌骨外移率,评估髌股关节的稳定性及改善情况。结果与结论:①两组术后6,12个月的目测类比评分均低于术前(P<0.05),术后6,12个月的Lysholm评分、Kujala髌股关节评分均高于术前(P<0.05);试验组术后6个月的Lysholm评分、Kujala髌股关节评分高于对照组(P<0.05),两组间术后12个月的目测类比评分、Lysholm评分、Kujala髌股关节评分比较差异无显著性意义(P>0.05);②两组术后12个月的髌股关节髌骨倾斜角、髌骨适合角、髌骨外移率及关节活动度测量值均较术前明显改善(P<0.05);试验组术后12个月的髌骨倾斜角小于对照组(P<0.05),两组间术后12个月的髌骨适合角、髌骨外移率及关节活动度及MRI评分比较差异无显著性意义(P>0.05);③结果表明,自体富白细胞-血小板纤维蛋白凝胶联合腘绳肌腱重建内侧髌股韧带能有效治疗创伤性髌骨脱位,改善膝关节功能,恢复髌骨的运动轨迹。 展开更多
关键词 富白细胞-血小板纤维蛋白凝胶 腘绳肌腱 创伤性髌骨脱位 内侧髌股韧带 组织工程
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膝前交叉韧带重建10年后自体和同种异体移植物成熟度及术后临床效果分析
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作者 崔勇 杨靖琦 +3 位作者 王建朝 邵德成 陈百成 张晓阳 《中国运动医学杂志》 CAS CSCD 北大核心 2024年第3期175-180,共6页
目的:评估并比较膝前交叉韧带重建10年后自体和异体移植物成熟度及术后临床效果。方法:对64名前交叉韧带重建的患者进行平均约10年的回顾性分析。其中自体移植物36例(56.2%),同种异体移植物28例(43.8%),记录两组患者的膝关节Lysholm评分... 目的:评估并比较膝前交叉韧带重建10年后自体和异体移植物成熟度及术后临床效果。方法:对64名前交叉韧带重建的患者进行平均约10年的回顾性分析。其中自体移植物36例(56.2%),同种异体移植物28例(43.8%),记录两组患者的膝关节Lysholm评分、IKDC主观评分和稳定性试验结果(KT-1000侧-侧差值、Lachman试验),并通过膝关节磁共振成像(MRI)扫描,记录两种移植物的成熟度[信噪比(SNQ)]、对两组患者的上述指标进行对比分析。结果:术后平均随访时间自体移植物组为10.1±2.1年,同种异体移植物组为10.5±1.8年,两组间差异无统计学意义(P=0.376);SNQ值自体移植物组为24.1±8.8,同种异体移植物组为23.2±8.7,两组间差异无统计学意义(P=0.652);Lysholm评分自体移植物组为90±10.3分,同种异体移植物组为89.4±8.9分,两组间差异无统计学意义(P=0.805);IKDC评分自体移植物组(84.5±8.3分)高于同种异体移植物组(80.4±7.8分),但两组间差异无统计学意义(P=0.075);KT1000测量韧带紧张度异常的发生率,同种异体移植物组(14.3%)高于自体移植物组(8.3%),但差异无统计学意义(P=0.724);两组患者术后随访时的关节前向稳定性差异无统计学意义(P=0.923);自体移植物组中2例发生ACL再撕裂(5.6%),同种异体移植物组为2例(7.1%),两组间差异无统计学意义(P=0.795)。结论:在ACLR术后平均10年的患者中,使用自体或同种异体移植物的两组患者的移植物成熟度差异无统计学意义,两组间的临床效果、关节稳定性差异无统计学意义,移植物再撕裂率相当。 展开更多
关键词 前交叉韧带 信噪比 腘绳肌腱 同种异体肌腱 临床效果
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自体腓骨长肌腱移植重建前交叉韧带术后对供区踝关节和下肢功能影响的研究
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作者 范友强 许光旭 +4 位作者 马明 高瑞芳 汤昆 郭建业 许如炜 《中国康复医学杂志》 CAS CSCD 北大核心 2024年第8期1168-1173,1193,共7页
目的:观察采用自体腓骨长肌腱(PLT)移植重建膝关节前交叉韧带术后对供区踝关节和下肢运动功能的影响。方法:纳入2021年6月—2022年8月在东南大学附属中大医院和常州市体育医院就诊采用自体腓骨长肌腱移植患者23例(PLT组),对照组招募同... 目的:观察采用自体腓骨长肌腱(PLT)移植重建膝关节前交叉韧带术后对供区踝关节和下肢运动功能的影响。方法:纳入2021年6月—2022年8月在东南大学附属中大医院和常州市体育医院就诊采用自体腓骨长肌腱移植患者23例(PLT组),对照组招募同时期采用自体腘绳肌腱移植患者23例。两组患者性别、年龄、BMI、术侧等一般资料无显著性差异(P>0.05),分别比较手术6个月后PLT组患侧与同组健侧、对照组患侧之间踝关节内外翻的相对峰力矩、关节活动度、本体感觉、VAS、足踝功能评分、Lysholm评分、平衡和单足跳等下肢运动功能情况。结果:与同组健侧和对照组相比,PLT组患侧踝关节的VAS、足踝功能评分、内外翻活动度和本体感觉方面无显著性差异(P>0.05);而在60°和180°角速度下的踝外翻相对峰力矩下降、内外翻力矩比值(I/E)升高、平衡功能内外向摆幅和运动轨迹长增加(均P<0.05);与对照组相比,PLT组患侧下肢单足跳距离和下肢对称指数相对更好(P<0.05)。结论:PLT移植重建ACL具有良好的功能预后,对供区踝关节VAS、关节活动度、本体感觉和足踝功能评分影响不大,且下肢整体运动功能相对更优,但供区踝外翻肌力、内外翻力矩比(I/E)和下肢平衡功能均下降,应给予关注,以有利于制定更有针对性的康复处方。 展开更多
关键词 前交叉韧带 腓骨长肌腱 腘绳肌肌腱 足踝功能 平衡 康复
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自体同侧腓骨长肌腱和腘绳肌腱重建后交叉韧带的效果分析
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作者 姜定君 李俊 +4 位作者 路晓 周铭剑 侯刚 何洲 徐杨俊 《外科研究与新技术(中英文)》 2024年第2期115-119,共5页
目的在后交叉韧带断裂患者中采用自体同侧腓骨长肌腱(PLT)重建,并与腘绳肌腱(HT)重建比较,分析其安全性与有效性。方法回顾性分析收治的后交叉韧带断裂行重建手术患者,根据取材不同分为PLT组(22例,采用自体同侧腓骨长肌腱重建)和HT组(20... 目的在后交叉韧带断裂患者中采用自体同侧腓骨长肌腱(PLT)重建,并与腘绳肌腱(HT)重建比较,分析其安全性与有效性。方法回顾性分析收治的后交叉韧带断裂行重建手术患者,根据取材不同分为PLT组(22例,采用自体同侧腓骨长肌腱重建)和HT组(20例,采用自体腘绳肌腱重建)。观察指标包括围手术期情况、随访期指标及影像学评估。结果两组患者的各项围手术期指标差异均无统计学意义;PLT组患者的不良反应发生率明显小于HT组。末次随访时,PLT组患者的膝关节评分和影像学指标明显优于HT组。结论在后交叉韧带损伤重建的患者中应用自体同侧腓骨长肌腱治疗可高效恢复膝关节功能、缓解疼痛症状和促进关节活动,并规避手术创伤对康复的影响。 展开更多
关键词 后交叉韧带损伤 自体肌腱 腓骨长肌腱 腘绳肌腱
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关节镜自体腘绳肌腱重建前交叉韧带术后引流的早期疗效比较
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作者 段于平 赵华磊 +2 位作者 费学良 唐永新 徐永升 《昆明医科大学学报》 CAS 2024年第1期122-126,共5页
目的 探究关节镜自体腘绳肌腱重建前交叉韧带术后,不放引流是否会对临床疗效造成影响。方法 2022年3月至2023年6月,59名在临沧市人民医院行关节镜自体腘绳肌腱重建前交叉韧带术的患者,随机分为不使用引流组29例(观察组),使用引流24 h组3... 目的 探究关节镜自体腘绳肌腱重建前交叉韧带术后,不放引流是否会对临床疗效造成影响。方法 2022年3月至2023年6月,59名在临沧市人民医院行关节镜自体腘绳肌腱重建前交叉韧带术的患者,随机分为不使用引流组29例(观察组),使用引流24 h组30例(对照组)。记录2组患者术后第1、3、7、14、30天疼痛情况(采用视觉模拟量表),膝关节活动度,住院时间,术后并发症发生情况;测量术前及术后大腿周径,计算出差值。结果 经重复测量资料的方差分析,疼痛评分、大腿周径和膝关节活动度主体内效应差异均有统计学意义(P <0.05),主体间效应差异均无统计学意义(P> 0.05)。经两独立样本t检验:术后第1天,观察组疼痛评分低于对照组(P <0.001),大腿周径、膝关节活动度高于对照组(P <0.05)。其余随访时间2组患者疼痛评分、膝关节活动度、大腿周径比较,差异均无统计学意义(P> 0.05);观察组住院时间少于对照组(P <0.001);2组患者均无下肢神经损伤、深静脉血栓、膝关节感染、需要穿刺和抽吸的血肿等并发症。结论 关节镜自体腘绳肌腱重建前交叉韧带术后,不放引流在术后早期对患者疼痛、膝关节活动度、大腿周径等临床疗效没有影响。且不放引流减少患者术后第1天的疼痛程度,改善膝关节活动度,减少住院天数。因此,在关节镜自体腘绳肌腱重建前交叉韧带术后,不建议常规预防性使用引流。 展开更多
关键词 前交叉韧带重建 引流 腘绳肌腱
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Autologous Tendon Grafts Used in Upper Limb Surgery 被引量:1
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作者 Avinash Alva V. Kumar +2 位作者 R. Sreekumar Chye Yew Ng S. C. Talwalkar 《Open Journal of Orthopedics》 2013年第2期74-78,共5页
Tendon autografts play an important role in upper limb reconstruction and a working knowledge of tendon autograft options is essential for the surgeon. Although palmaris longus is often the first choice, other options... Tendon autografts play an important role in upper limb reconstruction and a working knowledge of tendon autograft options is essential for the surgeon. Although palmaris longus is often the first choice, other options like plantaris, extensor Hallucis longus, flexor carpi radialis are readily available. Advantages of autografts include easy availability, satisfactory biomechanical properties and the human body tends to accept its own tendons than from a donor. This review highlights the various options available and their anatomical and surgical considerations in procuring grafts for upper limb reconstructive work. 展开更多
关键词 AUTOLOGOUS tendon Graft Palmaris Longus PLANTARIS EXTENSOR Digitorum Longus EXTENSOR Hallucis Longus FLEXOR Carpi Radialis hamstringS
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自体与同种异体腘绳肌腱重建前交叉韧带的疗效比较 被引量:2
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作者 王剑 《临床骨科杂志》 2023年第2期202-206,共5页
目的 比较关节镜下保留残端自体腘绳肌腱与同种异体腘绳肌腱重建前交叉韧带的疗效。方法 将45例前交叉韧带损伤患者按照治疗方法不同分为观察组(采用关节镜下保留残端自体腘绳肌腱重建治疗,25例)和对照组(采用关节镜下保留残端同种异体... 目的 比较关节镜下保留残端自体腘绳肌腱与同种异体腘绳肌腱重建前交叉韧带的疗效。方法 将45例前交叉韧带损伤患者按照治疗方法不同分为观察组(采用关节镜下保留残端自体腘绳肌腱重建治疗,25例)和对照组(采用关节镜下保留残端同种异体腘绳肌腱重建治疗,20例)。比较两组膝关节稳定性、术后并发症发生率、膝关节功能及膝关节活动度。结果 患者均获得随访,时间12~14个月。术后12个月MRI检查显示两组均腱骨愈合。KT-2000关节测量仪测量的两组双侧移动差值:术后3个月比较差异无统计学意义(P>0.05),术后6、12个月观察组均小于对照组(P<0.05)。末次随访时,两组Lachman试验均为阴性。两组术后并发症发生率比较差异无统计学意义(P>0.05)。术后3、12个月Lysholm评分观察组均高于对照组(P<0.05)。末次随访时,两组膝关节伸直、屈曲活动度比较差异均无统计学意义(P>0.05)。结论 与同种异体腘绳肌腱相比,关节镜下保留残端自体腘绳肌腱重建前交叉韧带有利于膝关节功能的恢复,且稳定性好。 展开更多
关键词 前交叉韧带损伤 关节镜检查 腘绳肌腱 韧带重建
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术前MRI测量腘绳肌腱横截面积与前交叉韧带重建中移植物的相关性研究 被引量:1
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作者 闫超超 杨定龙 +1 位作者 孙潇宇 焦强 《中国骨伤》 CAS CSCD 2023年第10期932-935,共4页
目的:探讨测量MRI腘绳肌腱横截面积在行前交叉韧带重建术前与前交叉韧带重建中移植物的相关性。方法:收集2021年11月至2022年3月在骨关节科拟行前交叉韧带重建术的50例患者的MRI资料,男32例,女18例,年龄19~48(31.1±8.7)岁。术前对... 目的:探讨测量MRI腘绳肌腱横截面积在行前交叉韧带重建术前与前交叉韧带重建中移植物的相关性。方法:收集2021年11月至2022年3月在骨关节科拟行前交叉韧带重建术的50例患者的MRI资料,男32例,女18例,年龄19~48(31.1±8.7)岁。术前对半腱肌和股薄肌腱进行MRI测量并记录,然后在关节镜下行前交叉韧带重建术,术中取股薄肌腱与半腱肌腱来制备最终所需移植的肌腱,并且在术中测量已制备好的最终移植物的直径。最后使用统计学软件分析得到数据。结果:MRI测量半腱肌肌腱横截面积、股薄肌肌腱横截面积、半腱肌肌腱与股薄肌肌腱横截面积之和与前交叉韧带术中所需移植物的直径大小呈显著正相关,r值分别为0.858、0.728、0.842(P<0.001),半腱肌肌腱与股薄肌肌腱横截面积之和的曲线下面积(area uder curve,AUC)、灵敏度、和特异性分别为0.925、90.48%、85.71%。结论:在进行前交叉韧带重建术的患者中,术前MRI测量与术中腘绳肌移植直径大小有具有较强的统计学相关性,半腱肌肌腱与股薄肌肌腱横截面积之和对于前交叉韧带重建术中移植物的直径大小有较高的预测价值,可以预测术中移植物的大小。 展开更多
关键词 腘绳肌腱 横截面积 前交叉韧带重建 磁共振成像
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前交叉韧带重建移植物选择的研究进展 被引量:1
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作者 冯建豪 王家骐 《外科研究与新技术》 2023年第2期125-130,140,共7页
前交叉韧带(anterior cruciate ligament,ACL)是膝关节内重要的前向稳定结构,同时也是运动中最易损伤结构之一。ACL损伤会限制患者运动功能,如不能及时治疗,常继发半月板、关节软骨损伤,甚至创伤性骨关节炎等严重并发症。目前,ACL重建... 前交叉韧带(anterior cruciate ligament,ACL)是膝关节内重要的前向稳定结构,同时也是运动中最易损伤结构之一。ACL损伤会限制患者运动功能,如不能及时治疗,常继发半月板、关节软骨损伤,甚至创伤性骨关节炎等严重并发症。目前,ACL重建是目前ACL损伤标准治疗方式,而移植物选择对患者术后功能恢复和手术成功率具有重要影响。自体移植物是目前最常用的移植物,且疗效最为稳定,但存在来源有限与取腱并发症等缺点。异体移植物适用性更广,但又带来疾病传播与免疫排斥的风险。人工韧带适用于急需重返运动人群,但技术难度高,且缺乏长期有效性报道。因此,传统移植物存在诸多问题,近年来快速发展的组织工程技术正为ACL重建提供新思路。本文综述了ACL重建中各种移植物优缺点与临床疗效,以期为ACL损伤的治疗提供帮助。 展开更多
关键词 膝关节 前交叉韧带 移植物 腘绳肌腱 组织工程 重建
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前外侧韧带重建在前交叉韧带损伤重建中的应用 被引量:2
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作者 赵之颢 白和提叶尔·吐尔干 +1 位作者 梁振 洪凯峰 《疑难病杂志》 CAS 2023年第6期636-639,645,共5页
目的研究前交叉韧带(ACL)损伤重建中应用前外侧韧带(ALL)重建的效果。方法选取2017年10月—2020年10月在乌鲁木齐市友谊医院骨一科接受治疗的ACL损伤患者120例为研究对象,根据标准随机化设计将患者分为2组各60例,观察组接受腘绳肌腱(HT)... 目的研究前交叉韧带(ACL)损伤重建中应用前外侧韧带(ALL)重建的效果。方法选取2017年10月—2020年10月在乌鲁木齐市友谊医院骨一科接受治疗的ACL损伤患者120例为研究对象,根据标准随机化设计将患者分为2组各60例,观察组接受腘绳肌腱(HT)+ACL联合同种异体肌腱(AT)+ALL重建,对照组接受HT+ACL重建,随访2年,比较2组临床疗效、治疗安全性与有效性。结果2组国际膝关节论证委员会(IKDC)评分、Teg⁃ner活动度评定量表(Tegner评分):术前<术后6个月<术后1年<术后2年,观察组术后6个月、1年、2年的IKDC评分、Tegner评分均高于对照组(IKDC:t/P=10.023/<0.001,16.074/<0.001,7.520/<0.001;Tegner t/P=4.532/<0.001,4.550<0.001,5.636/<0.001)。2组视觉模拟评分法(VAS)评分:术前>术后6个月>术后1年>术后2年,Lysholm膝关节评分量表(Lysholm评分):术前<术后6个月<术后1年<术后2年,观察组术后6个月、1年的VAS评分低于对照组,Lysholm评分术后6个月、1年均高于对照组(VAS:t/P=4.771/<0.001,5.298/<0.001;Ly⁃sholm:t/P=8.135/<0.001,7.351/<0.001),2组术后2年的VAS、Lysholm评分比较差异均无统计学意义(P>0.05)。术后2年,2组内植物断裂率比较差异无统计学意义(P>0.05),观察组重返伤前运动率明显高于对照组(86.87%vs.71.67%,χ^(2)=4.093,P=0.043)。结论ALL重建有利于促进ACL损伤患者的膝关节功能恢复,改善患者疾病症状并减少疼痛,临床治疗安全性与有效性均有保障。 展开更多
关键词 前交叉韧带损伤 前外侧韧带重建 腘绳肌腱 同种异体肌腱
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Comparative study of the clinical efficacy of all-inside and traditional techniques in anterior cruciate ligament reconstruction 被引量:1
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作者 Bai-Jing An Yao-Ting Wang +2 位作者 Zhe Zhao Ming-Xin Wang Geng-Yan Xing 《World Journal of Clinical Cases》 SCIE 2023年第14期3195-3203,共9页
BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniq... BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction. 展开更多
关键词 Anterior cruciate ligament reconstruction All-inside quadrupled semitendinosus Clinical curative effect Traditional hamstring tendon Visual analogue scale
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关节松弛程度对关节镜自体腘绳肌腱重建术疗效的影响 被引量:1
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作者 范存帅 《长治医学院学报》 2023年第5期349-353,共5页
目的:观察术前关节松弛程度对前交叉韧带损伤行关节镜自体腘绳肌腱重建术疗效的影响,及与术后关节稳定性的相关性。方法:选择80例前交叉韧带损伤患者作为研究对象,根据入院时关节松弛程度评估情况,将beighton关节过度运动评分量表≥4分... 目的:观察术前关节松弛程度对前交叉韧带损伤行关节镜自体腘绳肌腱重建术疗效的影响,及与术后关节稳定性的相关性。方法:选择80例前交叉韧带损伤患者作为研究对象,根据入院时关节松弛程度评估情况,将beighton关节过度运动评分量表≥4分的45例患者作为阳性组(全身关节韧带松弛),评分<4分的35例患者作为阴性组(全身关节韧带正常),2组患者均接受关节镜自体腘绳肌腱重建术治疗,比较2组患者膝关节功能、膝关节本体感觉功能恢复情况,对所有患者随访半年,比较2组关节稳定性改善情况。通过spearman相关性系数检验术前关节松弛程度与术后关节稳定性的相关性。结果:治疗前,2组患者膝关节功能、膝关节本体感觉功能、关节稳定性差异均无统计学意义(P>0.05);治疗后,阳性组的lysholm膝关节功能评分为(85.45±5.31)分,tegner膝关节运动评分为(6.12±2.33)分,国际膝关节评分委员会量表(IKDC)评分为(85.75±5.26)分,均低于阴性组[(88.49±5.36)分、(7.41±2.26)分、(88.39±5.42)分],差异有统计学意义(P<0.05);治疗后,阳性组的膝关节本体被动重新定位角度绝对误差值为1.26±0.37,被动运动察觉阈值时间为(1.62±0.45)s,均高于阴性组[(0.77±0.26)s、(0.75±0.31)s],差异有统计学意义(P<0.05);随访期间,阳性组内侧副韧带(MCL)为(16.75±5.31)°,外侧副韧带(LCL)为(7.72±2.41)°,均高于阴性组[(13.39±5.37)°、(6.14±2.88)°],阳性组kneelax测量值为(4.23±1.45)mm,低于阴性组(5.12±1.41)mm,差异有统计学意义(P<0.05);经spearman相关性系数检验,术前beighton评分与术后内侧、外侧副韧带活动度评分呈正相关,与kneelax测量值呈负相关。结论:关节镜自体腘绳肌腱重建术可有效改善前韧带交叉损伤患者的膝关节活动功能、本体感觉功能及关节稳定性,但其手术疗效可受术前关节松弛度影响,在术前综合评估关节功能并针对性干预对增强手术疗效有积极作用。 展开更多
关键词 前交叉韧带损伤 自体腘绳肌腱重建术 关节松弛度 关节稳定性
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